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| Molecular Cancer Research | Cell Growth & Differentiation |
: A Role for Bcl-21
Departments of Medicine [S. W. T., K. D., D. C. P., B. A. A.] and Pharmacology [M. K. B., A. E.], Dartmouth Medical School, Hanover, New Hampshire 03755
| Abstract |
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-induced cell death. We abrogated the TGF-ß
autocrine loop by overexpression of a truncated TGF-ß type II
receptor in MCF-7 breast carcinoma cells and found that this generated
resistance to TNF-
-induced cytotoxicity. To elucidate the molecular
basis of the influence of TGF-ß on TNF-
-induced cytotoxicity, we
evaluated the expression levels or activities of proteins involved in
TNF-
signal transduction or the regulation of apoptosis in general
in TGF-ß-responsive and TGF-ß-nonresponsive MCF-7 cells. We
observed no significant difference in the expression of TNF-
receptors or the TNF receptor-associated death domain protein. In
addition, downstream activation of nuclear factor
B by TNF-
was
not altered in cells that had lost TGF-ß responsiveness. Analysis of
members of the Bcl-2 family of apoptosis-regulatory proteins revealed
that Bcl-XL and Bax expression levels were not changed by
disruption of TGF-ß signaling. In contrast, the TGF-ß-nonresponsive
cells expressed much higher levels of Bcl-2 protein and mRNA than did
cells with an intact TGF-ß autocrine loop. Furthermore, restoration
of a TGF-ß signal to MCF-7 cells that had spontaneously acquired
resistance to TGF-ß caused a reduction in Bcl-2 protein expression.
Taken together, our data indicate that loss of autocrine TGF-ß
signaling results in enhanced resistance to TNF-
-mediated cell death
and that this is likely to be mediated by derepression of Bcl-2
expression. | Introduction |
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Among the least understood aspects of TGF-ß biology is its role in regulating apoptosis and cell death. Many groups have documented an increase in TGF-ß mRNA and/or protein as an early event in the apoptotic cascade. Examples of increased TGF-ß production by cells undergoing apoptosis include removal of hormone from hormonally dependent epithelia (5, 6, 7) , antimetabolite-induced apoptosis of hormone-independent tumor cells (8) , and treatment of human mammary carcinomas with pharmacological doses of antiestrogens (9 , 10) . What remains unclear, however, is whether the observed rise in TGF-ß is an integral component of the apoptotic cascade or whether it is simply a consequence of the cytotoxic insult.
An investigation by Danforth and Sgagias (11)
attempted to
elucidate the role, if any, of TGF-ß as a determinant of cell death
induced by TNF-
. TNF-
is an inflammatory cytokine capable of
binding and activating cell surface receptors (TNF-RI and TNF-RII).
TNF-RI is a member of a family of death-inducing receptors that
includes Fas/CD95 and death receptor 3. Binding of TNF-
to TNF-RI is
responsible for the generation of many of the known cellular responses
of TNF-
, including apoptosis and activation of NF-
B
(12)
. Danforth and Sgagias (11)
observed that
breast cancer cell lines that were susceptible to TNF-
-mediated
cytotoxicity exhibited an increase in TGF-ß production within 2448
h after exposure to TNF-
and before cell death. On coincubation with
neutralizing anti-TGF-ß antibody, they observed no suppression of
TNF-
-mediated killing and therefore concluded that TGF-ß played no
critical role in this process. However, this experimental strategy
cannot rule out the possibility that TGF-ß is involved in autocrine
regulation of apoptosis because exogenous antibody may not gain access
to all of the TGF-ß capable of eliciting an effect.
A more definitive test of the hypothesis that an autocrine effect
of TGF-ß plays an important role in the TNF-
-mediated apoptotic
death of the cell could be accomplished by specific and complete
abrogation of the TGF-ß pathway. We therefore transfected MCF-7 cells
that are sensitive to both TGF-ß and TNF-
with a truncated
TßR-II. Others have demonstrated that when overexpressed, a truncated
TßR-II acts in a dominant negative fashion, resulting in loss of
TGF-ß responsiveness (13)
. Comparison of the resulting
TGF-ß-nonresponsive cells to their TGF-ß-responsive counterparts
demonstrated that the autocrine production of TGF-ß sensitizes cells
to the cytotoxic effects of TNF-
. Analysis of TNF-
signaling and
expression of apoptosis-regulating genes in these cells has
implicated TGF-ß-mediated repression of Bcl-2 expression as the
potential underlying mechanism for our observations.
| Results |
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-induced Cytotoxicity.
results in up-regulation of the production and secretion of
TGF-ß by the treated cells (11)
. To evaluate whether
TGF-ß signaling plays a functional role in TNF-
-induced
cytotoxicity, the MCF-7/EZ and MCF-7/TREZ clones were treated with a
wide range of TNF-
concentrations for 5 days (Fig. 3)
, characterized by an
IC50 of 100 units/ml. In contrast, the
TGF-ß-nonresponsive MCF-7/TREZ clones were relatively resistant to
TNF-
-induced cell death and displayed an IC50
of 800 units/ml. This 8-fold increase in IC50
indicates that TGF-ß signaling via an autocrine loop does play a role
in facilitating TNF-
-induced cytotoxicity. To confirm that TNF-
was causing cytotoxicity rather than simply growth arrest, cells were
assayed for their viability, as measured by the ability to exclude
trypan blue. These experiments verified that TNF was indeed resulting
in cell death. Specifically, the viability of the TGF-ß-responsive
MCF-7/EZ clones after a 5-day treatment with 1000 units/ml TNF was
28.7 ± 4.7%, whereas the viability of the TGF-ß-nonresponsive
MCF-7/TREZ clones was 60.0 ± 7.6% (P = 0.0002).
We did not observe the changes in cell shape or chromatin condensation
typically associated with apoptosis, consistent with the report of
Jänicke et al. (15)
that MCF-7 cells lack
caspase-3 and therefore do not demonstrate DNA fragmentation or visible
morphology changes on TNF killing.
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cell death pathway is initiated when TNF-
ligand binds
its receptor TNF-RI (p55), resulting in recruitment of TRADD to the
cytoplasmic death domain of the receptor (12)
. To assess
whether TGF-ß signaling affects the expression level of these two
proteins, Western analysis was conducted on cell lysates of
TGF-ß-responsive MCF-7/EZ clones and TGF-ß-nonresponsive MCF-7/TREZ
clones (Fig. 4)
-induced cytotoxicity cannot be attributed to changes in TNF-RI
or TRADD protein expression or to the ratio of TNF-Rs.
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B Is Activated in Response to TNF-
in Both
TGF-ß-responsive MCF-7/EZ Clones and TGF-ß-nonresponsive MCF-7/TREZ
Clones.
signaling, we evaluated known mechanisms of resistance to
TNF-
-induced cell death. Many studies have shown that activation
of the transcription factor NF-
B can provide an antiapoptotic
signal, thereby promoting cell survival (16, 17, 18)
.
Moreover, evidence in the literature has established that TGF-ß
treatment can inhibit activation of NF-
B in certain systems
(19)
. To determine whether TGF-ß is attenuating NF-
B
activity in MCF-7 cells, thereby resulting in enhanced sensitivity to
TNF-
-mediated cell death, NF-
B activity in nuclear extracts of
MCF-7/EZ and MCF-7/TREZ clones after treatment with TNF-
was
measured by gel shift assay (Fig. 5A)
B activation in response to TNF-
are equivalent in both TGF-ß-responsive and -nonresponsive clones,
and the maximum activity appears to be reached within the first hour of
treatment. In addition to assaying NF-
B DNA binding activity by gel
shift, the transcriptional activity of NF-
B was measured using a
NF-
B-responsive luciferase reporter construct (Fig. 5B)
B transcriptional
activity in response to TNF-
treatment is equal in the MCF-7/TREZ
and MCF-7/EZ clones. These results indicate that the effect of TGF-ß
on TNF-
-induced cytotoxicity is not mediated by changes in NF-
B
activity. Additionally, these data emphasize that although the
TGF-ß-nonresponsive MCF-7/TREZ clones are resistant to the cytotoxic
effects of TNF-
, they are still capable of responding to TNF-
ligand and that certain branches of the TNF-
signaling cascade
remain as sensitive as they are in the TGF-ß-responsive MCF-7/EZ
controls.
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-induced cell death by
modulating the expression of Bcl-2 family members, Western analysis was
conducted on cell lysates of TGF-ß-responsive MCF-7/EZ and
TGF-ß-nonresponsive MCF-7/TREZ clones (Fig. 6)
-induced
cytotoxicity. When the TGF-ß autocrine loop is no longer functional,
as in the MCF-7/TREZ clones, high levels of Bcl-2 expression result,
leading to increased resistance to TNF-
-induced cell death.
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-mediated cell death and express a level of Bcl-2 comparable to
that in the MCF-7/TREZ cells (data not shown). Activation of the
TGF-ß signal transduction cascade in these cells was achieved by
transfection of a novel expression construct for a chimeric protein in
which the cytoplasmic kinase domains of TßR-I and TßR-II are
tethered to each other, thereby bypassing any receptor defect
(25)
. In three separate transient transfections of this
construct, in which transfection efficiencies of 3040% were
documented by parallel transfections of an expression plasmid for green
fluorescent protein, Bcl-2 protein levels were reduced to 50% of
transfected controls, on average (P = 0.027). Fig. 7
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| Discussion |
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toward human breast cancer MCF-7 cells
because the kinetics and magnitude of TGF-ß induction after exposure
to TNF-
, but before cell death, have been well documented
(11)
. The studies reported here serve to highlight and
characterize an important role for TGF-ß in TNF-
-mediated killing,
possibly via the repression of Bcl-2 expression.
We tested the hypothesis that TGF-ß signaling was an important
feature of TNF-
killing by stable transfection of MCF-7 cells, which
were responsive to both cytokines, with a dominant negative truncated
TßR-II, thereby blocking functional signal transduction by TGF-ß.
We observed that MCF-7 cells transfected with control vector (MCF-7/EZ
clones) retained responsiveness to TGF-ß and susceptibility to
TNF-
-mediated cytotoxicity, whereas the cells transfected with the
truncated TGF-ß receptor (MCF-7/TREZ clones) were unresponsive to
TGF-ß and had acquired resistance to TNF-
killing. Our findings
differ from those of Danforth and Sgagias (11)
, who, in
similarly motivated experiments, determined that a neutralizing
anti-TGF-ß antibody had no effect on TNF-
-induced growth
inhibition of MCF-7 cells. A logical explanation for this apparent
discrepancy is that exogenously added antibody resulted in incomplete
neutralization of TGF-ß because it could not gain access to all of
the TGF-ß. For instance, some TGF-ß may be sequestered in the
compartment between the cells and the culture dish.
NF-
B is a downstream mediator of many of the biological activities
of TNF-
. After TNF binding to cell surface receptors, NF-
B is
liberated from its binding to I
B in the cytoplasm and translocates
to the nucleus to effect changes in gene expression. Of interest, some
of the genes that are induced by NF-
B in response to TNF are
protective of TNF-mediated cytotoxicity (16
, 18
, 30)
.
Indeed, constitutive activation of NF-
B has been associated with
marked resistance to killing by TNF-
(17)
. We therefore
performed experiments examining the induction of NF-
B activity in
response to TNF-
and observed no differences among our clones with
regard to the activation or functional activity of NF-
B, implicating
other mechanisms for the TNF resistance of our TGF-ß-nonresponsive
cell clones. It is worth emphasizing that the ability of the MCF-7/TREZ
cells to bind TNF-
and properly transduce its signal was not
altered, indicating that the overexpression of the dominant negative
TßR-II protein did not disrupt TNF-R function.
Further investigation into the molecular mechanism of our basic
observation has identified Bcl-2 as a potential intermediary of the
effect of TGF-ß. Two prior groups have evaluated the ability of Bcl-2
to protect breast cancer cells from TNF killing.
Jäättelä et al. (31)
reported
that increased expression of Bcl-2 in MCF-7 cells, achieved by
transfection of a Bcl-2 expression construct, resulted in marked
resistance to cytolysis by either TNF or Fas. Vanhaesebroeck et
al. (32)
observed only a modest reduction in
susceptibility to TNF-induced cytotoxicity in association with
increased expression of Bcl-2. Some of the observed differences may
relate to the use of MCF-7 cell variants that are in fact quite
distinct in many respects. Indeed, a recent direct comparison of three
MCF-7 variants revealed strikingly different degrees of TNF-
-induced
apoptosis, some of which directly correlated with differences in basal
expression of Bcl-2 (33)
. The importance of clonal
variants of MCF-7 cells with regard to responsiveness to TGF-ß has
been noted by many investigators and has recently been attributed to
defective membrane localization of TßR-II in some nonresponsive
clones (34)
. Our data suggest that some of the clonal
differences reported by others in Bcl-2 expression and perhaps in TNF
killing as well reflect underlying differences in TGF-ß
responsiveness among MCF-7 variants.
Our observations may also be relevant to recently published studies
involving a variety of cell systems, including gliomas, Schwann cells,
and endometrial epithelial cells, reporting a synergistic proapoptotic
effect of TGF-ß when combined with TNF-
or Fas
(35, 36, 37)
. Furthermore, the TGF-ß-inducing effect of
agents such as vitamin D may explain reports of their ability to
potentiate the cytotoxic effect of TNF-
(38)
. Clearly,
however, some cell systems have demonstrated TGF-ß-mediated
attenuation of cytotoxicity by TNF-
, underscoring the fact that
complex pathways will likely yield distinct results in different cell
types (39
, 40)
. Some of the differences in reported
effects of TGF-ß on TNF-
cytotoxicity may derive from cell
type-specific effects of TGF-ß on expression of Bcl-2. For instance,
down-regulation of Bcl-2 after exposure to TGF-ß has been observed in
leukemic cell lines, colonic adenoma cells, ovarian carcinoma cells,
and umbilical vein endothelial cells (21, 22, 23
, 41
, 42) . In
contrast, TGF-ß has been reported to increase the level of Bcl-2
expression in neuronal cells and rheumatoid synovial cells (20
, 43)
. Our observation of concordance between Bcl-2 mRNA and
protein expression among our clones indicates that the effect of
TGF-ß is not mediated through enhanced Bcl-2 protein turnover or
attenuation of translation of the Bcl-2 mRNA. We have transfected our
cell clones with a human Bcl-2 promoter construct containing the full
5' untranslated region and more than 2.5 kb of upstream promoter
sequence, driving the expression of luciferase (44)
. In
two experiments, we noted no significant differences in promoter
activity among the clones or effect of exogenous TGF-ß on
luciferase expression of transfected MCF-7/EZ cells (data not shown).
This suggests that the effect of TGF-ß on Bcl-2 expression in MCF-7
cells is either posttranscriptional, i.e., mediated by a
destabilization of Bcl-2 mRNA, or involves transcriptional regulatory
elements that are not contained within this promoter construct.
Dominant repression of Bcl-2 by TGF-ß may be an important element in a number of physiological processes, including apoptosis of the mammary gland during the immediate postlactational period (26 , 45) . Furthermore, loss of the normal TGF-ß/Bcl-2 axis of repression may have important implications in the development and treatment of some forms of malignancy. Disruption of TGF-ß signaling, either by loss of receptor function (46, 47, 48, 49) or due to defective downstream signal propagation (50, 51, 52) , has been reported in a wide range of cancers. Truncation of TßR-II via somatic mutation is an early and likely determining event in colon carcinogenesis in the setting of the hereditary nonpolyposis colorectal cancer syndrome (53) . Bcl-2 can protect cells from a wide range of injurious assaults, including those mediated by various forms of chemotherapy (54 , 55) . Although investigators have not yet correlated absence of functional TGF-ß signaling with resistance to anticancer therapy, such as might well accompany a presumed derepression of Bcl-2 expression, this consequence of the loss of TGF-ß responsiveness by tumors may represent its most pernicious manifestation.
| Materials and Methods |
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Cell Culture and Transfection.
The human breast cancer cell line MCF-7 was obtained from American Type
Culture Collection. For the experiments with the pXF1042 plasmid, a
clone of MCF-7 cells from Clontech (MCF-7 Tet/Off) was used. Cells were
maintained in DMEM:Hams F-12 supplemented with 10% fetal bovine
serum, 2.5 mM L-glutamine, 100 IU/ml
penicillin, and 100 µg/ml streptomycin at 37°C, 5%
CO2. To generate stable transfectants
overexpressing the truncated TßR-II, MCF-7 cells in 10-cm dishes were
transfected with 15 µg of the expression plasmid TREZ or control
plasmid EZ by calcium phosphate-mediated transfection
(58)
. Forty-eight h after transfection, the cells were
trypsinized and split into 10-cm dishes with selective media containing
50 µg/ml zeocin (Invitrogen). Zeocin-resistant clones were isolated,
expanded, and assayed for expression of the transfected gene by Western
blot analysis.
Cell Proliferation and Cytotoxicity Assays.
Cells were trypsinized, counted on a hemocytometer, and then plated in
a 96-well plate in triplicate at 3000 cells/well in the same
serum-containing medium used for routine cell culture. After 6 h,
recombinant human TNF-
or TGF-ß1 (R&D Systems) was added to each
well at various concentrations. The plates were incubated at 37°C,
5% CO2 for 5 days. The relative number of viable
cells in each well was determined by MTS reduction assay using
the Celltiter 96 kit (Promega) according to the manufacturers
instructions. In some experiments, cell viability was determined by
trypan blue exclusion. Cells were trypsinized and mixed with trypan
blue, and the number of blue cells and trypan blue-excluding cells was
determined by counting cells on a hemocytometer. Triplicate samples
were analyzed.
Gel Shift Assay.
Electrophoretic mobility shift assays of nuclear NF-
B were
conducted as described by Barchowsky et al.
(59)
. Cells were plated in 35-mm wells in triplicate. The
next day, cells were treated with 10,000 units/ml TNF-
for 1 or
4 h or left untreated. Nuclear extracts were harvested, and
protein content was determined by the BCA protein assay (Pierce). The
gel shift probe was a double-stranded NF-
B consensus oligonucleotide
(5'-AGTTGAGGGGACTTTCCCAGGC-3'; Promega) labeled at the 5' end with
32P (58)
. Two µg of nuclear
protein were incubated with 2 x 105 cpm of
5'-32P-labeled probe and then resolved by
electrophoresis in a 4% acrylamide gel under nondenaturing conditions.
The gel was then dried and exposed to autoradiographic film.
Luciferase Reporter Assay.
Cells were plated in 10-cm dishes and transfected with the
NF-
B-responsive p-55Ig
Luc plasmid (60)
by
LipofectAMINE (Life Technologies, Inc.). The following day, each 10-cm
dish was trypsinized, and the cells were divided equally among the
wells of a 6-well plate. Cells were treated in duplicate with 0, 100,
or 300 units/ml TNF-
at 37°C for 20 h. To prepare lysates,
cells were washed three times with cold PBS, suspended in 200 µl of
lysis buffer (1% Triton X-100, 25 mM glycylglycine, 15
mM MgSO4, 4 mM EGTA, and
1 mM DTT), and then centrifuged at 14,000 x
g for 5 min at 4°C. The supernatant was assayed for
luciferase activity in triplicate in a luminometer. This assay was
conducted in a 96-well plate format, with each well containing 20 µl
of lysate, 20 µl of lysis buffer, and 145 µl of assay buffer (25
mM glycylglycine, 15 mM
potassium phosphate, 15 mM
MgSO4, 4 mM EGTA, 2
mM ATP, and 1 mM DTT) with
the addition of 40 µl of luciferin solution (400
µM luciferin and 25 mM
glycylglycine) at the time each well was read. Luciferase activity of
each sample was normalized to the protein content of the lysates, which
was assessed by the BCA protein assay (Pierce).
Western Blot Analysis.
Cells were grown in 10-cm dishes, washed twice with cold PBS, and
scraped in 1 ml of PBS containing protease inhibitors (9.5 µg/ml
aprotinin, 10 µg/ml leupeptin, and 1 mM pefabloc). The
cells were transferred to a microfuge tube and then centrifuged at
150 x g to pellet the cells. The cell pellet was
resuspended in lysis buffer [50 mM
Tris-HCl (pH 8.0), 100 mM NaCl, and 0.5% NP40]
containing the same protease inhibitors. The lysates were shaken on ice
for 20 min, followed by centrifugation at 16,000 x g
for 10 min at 4°C to pellet insoluble material. The supernatant was
transferred to a microfuge tube and stored at -70°C. Protein
concentrations were determined by the BCA assay. Cell lysates were
resolved by SDS-PAGE and transferred to nitrocellulose membranes. The
membranes were blocked in 5% milk in TBS and incubated with primary
antibody diluted in 5% milk in TBST. After three washes in 5% milk in
TBST, the blots were incubated with horseradish peroxidase-conjugated
secondary antibody (Jackson Laboratories) diluted 1:2000, washed three
times in 5% milk in TBST, rinsed once in TBS, and then developed by
enhanced chemiluminescence (Amersham). All experiments involving
Western blot analyses were performed at least three times, and one
representative blot was used for the relevant figures.
Antibodies.
The antibodies used were as follows: (a) for TßR-II, L-21
(Santa Cruz Biotechnology; 100 µg/ml; used at 0.1 µg/ml; 1:1000);
(b) for TNF-RI, 1995-01 (Genzyme; 1 mg/ml; used at 10
µg/ml; 1:100); (c) for TNF-RII, 1888-01 (Genzyme; 1 mg/ml;
used at 10 µg/ml; 1:100); (d) for TRADD, T50320
(Transduction Laboratories; 250 µg/ml; used at 1 µg/ml; 1:250);
(e) for Bax, N-20 (Santa Cruz Biotechnology; 100 µg/ml;
used at 0.13 µg/ml; 1:750); (f) for
Bcl-XS/L, M-125 (Santa Cruz Biotechnology; 200
µg/ml; used at 2 µg/ml; 1:100); (g) for Bcl-2, M0887
(Dako; 320 µg/ml; used at 0.16 µg/ml; 1:2000); and (h)
for actin, N350 (Amersham; 300 µg/ml; used at 0.075 µg/ml;
1:4000).
RNA Preparation and Analysis.
Total RNA was prepared from cells using the Trizol reagent according to
manufacturers instructions (Life Technologies, Inc.), and 2 µg of
total RNA were used for synthesis of cDNA using random hexamer
primers and Moloney murine leukemia virus reverse transcriptase.
Equivalent cDNA synthesis between the clones was confirmed with
actin-specific primers. PCR of Bcl-2 cDNA was performed with 0.5
µM primers (5'-ACGACTTCTCCCGCCGCTACC;
5'-GTACAGTTCCAC- AAAGGCATCC) at an annealing temperature of 60°C
for 30 s and extension at 72°C for 30 s each cycle. Five
µl of reverse transcription reaction were used as template. These
primers span an intron and yield a 302-bp product, and no
product was obtained if reverse transcriptase was ommited from the cDNA
synthesis step.
Statistical Analysis.
Statistical significance of the experimental data was determined using
the two-tailed, unpaired Students t test.
P < 0.05 was considered significant.
| Acknowledgments |
|---|
B-responsive p-55g
Luc plasmid, and Dr. Andrew Zelenetz for
the BCL2-promoter construct (pGL2-BCL2). We are also grateful for
assistance in the analysis of NF-
B activation provided by Dr. Aaron
Barchowsky. | Footnotes |
|---|
1 Supported by Grants DAMD17-J-4287 and
DAMD17-J-4130 from the Department of Defense Breast Cancer Research
Program. ![]()
2 Supported by National Cancer Institute Training
Grant CA09658. ![]()
3 To whom requests for reprints should be
addressed, at Dartmouth Medical School, Kellogg Box 0128, Hanover, NH
03755. Phone: (603) 650-1550; Fax: (603) 650-1129; E-mail: Bradley.Arrick{at}dartmouth.edu ![]()
4 The abbreviations used are: TGF-ß,
transforming growth factor ß; TßR-I, TGF-ß type I receptor;
TßR-II, TGF-ß type II receptor; TNF, tumor necrosis factor; TNF-R,
tumor necrosis factor
receptor; NF-
B, nuclear factor
B; TBS,
Tris-buffered saline; TRADD, TNF receptor-associated death domain
protein; TBST, TBS and 0.05% Tween 20; MTS,
3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium
salt. ![]()
Received for publication 8/15/00. Revision received 12/19/00. Accepted for publication 12/20/00.
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D N Danforth Jr All trans-retinoic acid acts synergistically with hydroxytamoxifen and transforming-growth factor {beta} to stimulate apoptosis in MCF-7 breast cancer cells J. Endocrinol., November 1, 2004; 183(2): 395 - 404. [Abstract] [Full Text] [PDF] |
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J. S. Jeruss, C. D. Sturgis, A. W. Rademaker, and T. K. Woodruff Down-Regulation of Activin, Activin Receptors, and Smads in High-Grade Breast Cancer Cancer Res., July 1, 2003; 63(13): 3783 - 3790. [Abstract] [Full Text] [PDF] |
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